{"entity":{"id":"total-body-irradiation","kind":"technology","name":"Total body and total marrow irradiation","aka":[],"tldr":"Irradiating the whole body, or just the bones and marrow, to wipe out the patient's blood system and immune cells before a stem cell transplant.","summary":"Total body irradiation in several fractions over a few days, combined with chemotherapy, conditions patients for allogeneic transplant by killing residual leukaemia and suppressing the immune system so the donor graft can take. It remains standard for children and young adults with acute lymphoblastic leukaemia, where the FORUM trial showed better survival than chemotherapy-only conditioning. Total marrow and lymphoid irradiation uses IMRT or helical delivery to concentrate the dose on bone marrow and lymph nodes while sparing lungs, eyes and gut, allowing dose escalation or gentler conditioning.","status":"established","asOf":"2026-09-17","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Total_body_irradiation"}],"tags":["radiation-wave1"],"related":[],"cancers":["all-leukemia","aml"],"sections":["radiation"],"technologies":["allogeneic-hsct","imrt-igrt"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"principle":"A uniform (or marrow-targeted) dose to the entire haematopoietic system eradicates host marrow and immune cells before donor cells are infused.","strengths":["Reaches sanctuary sites drugs miss","Well-proven in paediatric ALL","Marrow-targeted forms spare organs"],"limitations":["Lung toxicity and growth effects in children","Infertility and second cancers","Demanding to plan and deliver"],"since":1970},"route":"/technologies/total-body-irradiation/","neighbours":{"cancer":[{"id":"all-leukemia","kind":"cancer","name":"Acute lymphoblastic leukaemia","route":"/cancers/all-leukemia/"},{"id":"aml","kind":"cancer","name":"Acute myeloid leukaemia","route":"/cancers/aml/"}],"section":[{"id":"radiation","kind":"section","name":"Radiation Therapy","route":"/fronts/radiation/"}],"technology":[{"id":"allogeneic-hsct","kind":"technology","name":"Allogeneic stem cell transplantation","route":"/technologies/allogeneic-hsct/"},{"id":"rejuv-tx-bone-eyes-kidneys-lungs","kind":"technology","name":"Bone, eyes, kidneys and lungs after transplant","route":"/technologies/rejuv-tx-bone-eyes-kidneys-lungs/"},{"id":"rejuv-paed-fertility-male","kind":"technology","name":"Fertility in boys and young men treated for cancer, including testicular tissue banking","route":"/technologies/rejuv-paed-fertility-male/"},{"id":"rejuv-paed-fertility-female","kind":"technology","name":"Fertility in girls and young women treated for cancer, including ovarian tissue freezing","route":"/technologies/rejuv-paed-fertility-female/"},{"id":"rejuv-tx-fertility-and-growth","kind":"technology","name":"Fertility, growth and what total body irradiation costs","route":"/technologies/rejuv-tx-fertility-and-growth/"},{"id":"rejuv-paed-growth-and-height","kind":"technology","name":"Growth and final height after treatment in childhood, and growth hormone","route":"/technologies/rejuv-paed-growth-and-height/"},{"id":"rejuv-tx-endocrine-and-cardiometabolic","kind":"technology","name":"Hormones, metabolism and the heart after transplant","route":"/technologies/rejuv-tx-endocrine-and-cardiometabolic/"},{"id":"imrt-igrt","kind":"technology","name":"IMRT / IGRT (modern external beam)","route":"/technologies/imrt-igrt/"},{"id":"rejuv-tx-late-effects-overview","kind":"technology","name":"Late effects after a stem cell transplant","route":"/technologies/rejuv-tx-late-effects-overview/"},{"id":"rejuv-tx-second-cancers","kind":"technology","name":"Second cancers after allogeneic transplant","route":"/technologies/rejuv-tx-second-cancers/"},{"id":"gvhd-lung-bronchiolitis-obliterans","kind":"technology","name":"The lungs after transplant: bronchiolitis obliterans syndrome","route":"/technologies/gvhd-lung-bronchiolitis-obliterans/"},{"id":"tomotherapy","kind":"technology","name":"TomoTherapy and Radixact (helical radiotherapy)","route":"/technologies/tomotherapy/"}]}}